There are following 3 stages –

  1. Cold Stage : Lassitude, headache, nausea, chilly sensation followed by rigor. Temperature shoots to 39 – 41oC with headache and vomiting. Skin first feels cold, later turns hot.  It lasts for ¼ to 1 hour.
  2. Heat Stage : Patient feels hot and casts off cloths. Skin is dry and hot to touch. Headache is intense but nausea commonly diminishes.  Pulse is full and rapid respiration. It last for 2-6 hours.
  3. Sweat Stage : Fever comes down with profuse sweating. Temperature drop rapidly to normal and skin is cold and pulse is slow. Patient is relieved and often falls asleep.

The febrile paroxysm occur with definite intermittent periodicity repeating every 3rd or 4th day depending upon species of the parasite.


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